Bel-Peña N, Mérida-de la Torre F J
Laboratorio Clínico, Hospital de la Serranía, Área de Gestión Sanitaria Serranía de Málaga, Ronda, Málaga, España.
Laboratorio Clínico, Hospital de la Serranía, Área de Gestión Sanitaria Serranía de Málaga, Ronda, Málaga, España.
Rev Calid Asist. 2015 Nov-Dec;30(6):297-301. doi: 10.1016/j.cali.2015.07.008. Epub 2015 Nov 3.
To check whether an intervention based on direct observation and complementary information to nurses helps reduce haemolysis when drawing blood specimens.
Random sampling study in primary care centres in the serrania de Málaga health management area, using a cross-sectional, longitudinal pre- and post-intervention design. The study period was from August 2012 to January 2015. The level of free haemoglobin was measured by direct spectrophotometry in the specimens extracted. It was then checked whether the intervention influenced the level of haemolysis, and if this was maintained over time.
The mean haemolysis measured pre-intervention was 17%, and after intervention it was 6.1%. A year later and under the same conditions, the frequency of haemolysis was measured again the samples analysed, and the percentage was 9% These results are low when compared to the level obtained pre-intervention, but are higher when compared to the levels obtained immediately after the intervention. The transport and analysis conditions were the same.
An intervention based on a direct and informative observation in the process of collecting blood samples contributes significantly to reduce the level of haemolysis. This effect is maintained in time. This intervention needs to be repeated to maintain its effectiveness. Audits and continuing education programs are useful for quality assurance procedures, and maintain the level of care needed for a good quality of care.
检验一项基于对护士进行直接观察及补充信息的干预措施，在采集血标本时是否有助于减少溶血。
在马拉加山脉健康管理区的初级保健中心进行随机抽样研究，采用干预前后的横断面纵向设计。研究期间为2012年8月至2015年1月。通过直接分光光度法测量所采集标本中的游离血红蛋白水平。然后检查该干预措施是否影响溶血水平，以及这种影响是否随时间持续存在。
干预前测得的平均溶血率为17%，干预后为6.1%。一年后，在相同条件下，再次对所分析的样本测量溶血频率，百分比为9%。与干预前获得的水平相比，这些结果较低，但与干预后立即获得的水平相比则较高。运输和分析条件相同。
在采集血样过程中基于直接且信息丰富的观察进行的干预，对降低溶血水平有显著作用。这种效果能随时间维持。需要重复此项干预以保持其有效性。审核和继续教育项目对质量保证程序有用，并能维持优质护理所需的护理水平。
